Acquired and progressive myelinated retinal nerve fibers in neurofibromatosis type 1.

Acquired myelinated retinal nerve fibers (MRNF) is rare. The reported cases occur after optic disk injuries. We describe a case of a patient with neurofibromatosis type 1 and bilateral optic pathway glioma, who after 3 years' follow-up developed unilateral MRNF. Optical coherence tomography of the optic nerve disclosed progressive increased thickness and hyper-reflectivity of the peripapillary retinal nerve fiber layer associated with the myelinization process. Although the patient remains asymptomatic, myelinization continues to progress.